Occupational exposure to disinfectants and asthma control in US nurses

Eur Respir J. 2017 Oct 5;50(4):1700237. doi: 10.1183/13993003.00237-2017. Print 2017 Oct.

Abstract

Disinfectant use has been associated with adverse respiratory effects among healthcare workers. However, the specific harmful agents have not been elucidated. We examined the association between occupational exposure to disinfectants and asthma control in the Nurses' Health Study II, a large cohort of female nurses.Nurses with asthma were invited in 2014 to complete two questionnaires on their current occupation and asthma (response rate 80%). Asthma control was defined by the Asthma Control Test (ACT). Exposure to major disinfectants was evaluated by a job-task-exposure matrix (JTEM).Analyses included 4102 nurses with asthma (mean age 58 years). Asthma control was poor (ACT score 16-19) in 12% of nurses and very poor (ACT score ≤15) in 6% of nurses. Use of disinfectants to clean medical instruments (19% exposed) was associated with poorly (OR 1.37; 95% CI 1.05-1.79) and very poorly (OR 1.88, 95% CI 1.38-2.56) controlled asthma (ptrend=0.004, after adjustment for potential confounders). Using JTEM estimates, exposure to formaldehyde, glutaraldehyde, hypochlorite bleach, hydrogen peroxide and enzymatic cleaners was associated with poor asthma control (all ptrend<0.05); exposure to quaternary ammonium compounds and alcohol was not.Use of several disinfectants was associated with poor asthma control. Our findings suggest targets for future efforts to prevent worsening of asthma control in healthcare workers.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, P.H.S.
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Asthma* / chemically induced
  • Asthma* / diagnosis
  • Asthma* / prevention & control
  • Disinfectants* / adverse effects
  • Disinfectants* / classification
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nursing* / methods
  • Nursing* / standards
  • Occupational Exposure* / adverse effects
  • Occupational Exposure* / analysis
  • Occupational Health / standards
  • Preventive Health Services / methods
  • Quality Improvement
  • Respiratory System / drug effects
  • Respiratory System / physiopathology
  • Surveys and Questionnaires

Substances

  • Disinfectants